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Comparison of propofol with propofol -midazolam for I-gel insertion in spontaneously breathing patients for elective day care procedures

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Original Article

Author Details : Bhavani Vaidiyanathan, S. Saravanakumar, Gomathi Karmegam

Volume : 3, Issue : 4, Year : 2016

Article Page : 525-528

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Abstract

Background and Aim: Supraglottic airway devices (SGA) offer certain advantages over endotracheal intubation, making them appropriate for outpatient anesthesia. The I-gel® is the innovative second generation supraglottic airway device from Intersurgical. I-gel offers unique advantages of easy insertion, reduced trauma, superior sealing pressure, and gastric access. Drugs such as propofol, sevoflurane are commonly used for supraglottic device insertion. The pharmacokinetic characteristics of Propofol allows for rapid onset and offset of drug effect with better blunting of airway reflexes compared to thiopentone. Midazolam is a well-established anaesthetic pre-medicant for short surgical procedures. There are innumerable studies on insertion of classic LMA with propofol but only few with I-gel. This prompted us to inspect the efficacy of propofol, and propofol–midazolam co-induction for I-gel insertion in spontaneously breathing patients for elective day care procedures. The primary aim of the study is to compare propofol and propofol-midazolam for ease of I-gel insertion.
Methods: Eighty patients, aged 18-45, were divided into two groups group P and Group PM. They received anaesthesia induction with propofol and propofol –midazolam after pre-medicating with Inj.Fentanyl 2micrograms/kg respectively. Patients in (group P) received IV normal saline 2ml followed by Propofol 2.5mg/kg for induction. Patients in (group PM) received IV Midazolam 0.04mg/kg three minutes before induction with propofol.
The following conditions were assessed for ease of I-gel insertion such as number of insertion attempts, Jaw relaxation, coughing and gagging. The total dose of propofol, hemodynamic changes during induction were the other parameters recorded.
Results: I-gel was successfully inserted at first attempt in 33 patient’s(80%) in group PM and 24 patients(60%) group P and it was statistically significant(p ?0.03). The total dose of propofol consumed in group P(45.5±8.165) was more compared to group PM(44.65±6.483)(p?0.002).
Conclusion: I-gel insertion was swifter with better hemodynamic stability in propofol-midazolam than propofol alone for day care surgeries.

Keywords: Supraglottic devices, I-gel, Propofol, Midazolam

How to cite : Vaidiyanathan B, Saravanakumar S, Karmegam G, Comparison of propofol with propofol -midazolam for I-gel insertion in spontaneously breathing patients for elective day care procedures. Indian J Clin Anaesth 2016;3(4):525-528

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